CH 17 – PHYSICAL DEVELOPMENT in LATE ADULTHOOD

LONGEVITY
Late Adulthood: 60 – 65 ten ölene kadar

 Young-old: 65 – 84
 Oldest-old: 85 ve üstü
 Consider functional age rather than chronological age!!
o In terms of the ability to function, an 85-year-old may be psychologically and physically
more fit than a 65-year-old.
 We should consider differences in biological, chronological, psychological, and social age.
(chronological age  how long you have existed,
biological age  how old your cells are. yani physical age)

Life Expectancy and Life Span

Life Span: max number of years an individual can live, remained between 120-125 years.
Across, all species females outlive males.

 Women have more resistance to infections and degenerative diseases.

 The additional X chromosome may help woman to produce more antibodies to fight off disease.

Life Expectancy: number of years the average person born in particular year with probably live

Differences in life expectancy across countries

 Factors such as health conditions and medical care

 Ethnic differences

Cross-Cultural Differences

 Japan has the highest life expectancy at birth (84.26)

 Some African countries have the lowest (e.g., Lesotho, Central African Republic, Somalia)
– 50 56 years)
 Turkey (78.62 years) is the 39th among 182 nations
 Differences in life expectancy across countries are due to factors such as health conditions and
medical care.

Global trends in life expectancy and healthy life expectancy (HALE)

 Globally, life expectancy has increased by more than 6 years between 2000 and 2019 from 66.8
years in 2000 to 73.4 years in 2019.

 While HALE has also increased by 8% from 58.3 in 2000 to 63.7, in 2019.
 This was due to declining mortality rather than reduced years lived with disability
  In other words, the increase in HALE (5.4 years) has not kept pace with the increase in life
expectancy (6.6 years)

Cross-Cultural Differences:
The Case of Okinawans

 Living longer in Japanese island of Okinawa

 Longevity may be linked to
o Diet: heavy on fish, grains, vegetables; light on meat and dairy products
o Low-stress life
o Caring community
o Activity
o Spirituality
 The life expectancy of Okinawans who immigrated to Brazil decreased 17 years
o They changed their food habits in Brazil

The Young-Old and The Oldest-Old

Number of centenarians is increasing.

 Getting older may not mean getting sicker.

 Many centenarians are women.
o But men are more likely to be healthier than women  for men to reach at that old age,
they need to be exceptionally healthy.
 Ability to cope successfully with stress
 Other important factors:
o Genes and family history
o Education, personality, and lifestyle

Biological Theories of Aging

Evolutionary theory: natural selection has not eliminated many harmful conditions and nonadaptive
characteristics in older adults.

 Benefits conferred by evolution decline with age because natural selection is linked to
reproductive fitness.

Genetic/Cellular Process Theories:

Cellular Clock Theory

 Cells can divide a maximum of 75-80 times

 With age, cells become less capable of dividing
 Estimations based on cell -division: the maximum human life span can be 120 –125 years
Why do cells die?

 Telomeres are DNA sequences that cap chromosomes

o They get shorter each time a cell divides  after 70-80 replications, their length is
dramatically reduced; the cell can no longer reproduce
 Injecting telomerase, an enzyme, can extend the life of a telomere
o In 85% of the cancerous cells the enzyme telomerase were found
o Telomerase injection may not be producing a healthy life extension

Free – Radical Theory

ppl age because when cells metabolize energy, the by-products include unstable O2 molecules, or free
radicals.

 Free radicals  molecules that have a missing electron,

o They are unstable because they seek an extra electron to become stable
 Free radicals damage DNA and other cellular structures by ricocheting (sekmek)
 Overeating is linked with the increase in free radicals.
o Calorie restriction with an adequate amount of protein, vitamin, and mineral intake
reduces oxidative damage
 Exercise may help in reducing the oxidative damage

Mitochondrial Theory
Aging is due to the decay of mitochondria.

 Mitochondria  tiny bodies that supply energy for cell function, growth, and repair
 The decay is due to oxidative damage and loss of critical nutrients
Decay in mitochondrial activity is associated with DEMENTIA, CARDIOVASCULAR DISEASE, and DECLINE
in LIVER FUNTIONUNG

 Exercise helps to maintain mitochondrial activity

6 tips to reduce the stress hormone, cortisol:

Hormonal Stress Theory
Aging in the body’s hormonal system increase the
likelihood of disease.

 Hormonal system becomes inefficient to regulate

stress hormones
o Prolonged, elevated (high) levels of stress
hormones are associated with increased
risks for many diseases
o Diminished restorative process increase
the effects of aging on immunity
THE COURSE of PHYSICAL DEVELOPMENT in LATE ADULTHOOD
The Aging Brain
The brain is shrinks about 5-10% bw ages of 20-90

 VOLUME decreases – especially in frontal lobes & hippocampus

o Linked to decreased working memory and other cognitive functioning
 Shrinkage of neurons
 Reduced tree-like branching in dendrites
 Lower numbers of synapses
 Reduced length and complexity of axons

Slowing of function in the brain & spinal cord

 Begins in the middle adulthood and accelerates in late adulthood

 Affects physical coordination and intellectual performance

A reduction in certain neurotransmitters

 DOPAMINE
o Normal level reduction  problems in planning, carrying out motor activities
o Severe level reduction  loss of motor control and diseases such as Parkinsons
 ACETYLCHOLINE
o Normal level reduction  decline in memory
o Severe level loss associated with Alzheimer’s disease
 GABA
o Decline in preciseness (accuracy) of neural communication

Adapting Brain
Aging brain adapts in several ways

 Neurogenesis: the generation of new neurons

o Experiments with animals (e.g., rats): exercise and environmental stimulation produces
new neurons
o Neurogenesis in humans only in two regions  hippocampus & olfactory bulb

 Dendrite growth increases from the ages 40’s through 70’s

o After 90’s dendritic growth no longer takes place
o May be linked to lack of enough stimulation in the environment
 Older brains rewire to compensate for losses
 Hemispheric lateralization can decrease; may be a way of compensation to improve cognitive
functioning
Sleep
50 % of older adults report having difficulty sleeping.

 Linked to health and mental health problems

 Linked to lower level of cognitive functioning
 Sleeping too much predicts earlier all-cause morality

Strategies to help older adults sleep better at night include

 Avoiding caffeine
 Avoiding over-the-counter sleep remedies
 Staying physically active during the day
 Staying mentally active
 Limiting naps

The immune system  declines in functioning

 Extended duration of stress; diminished restorative process

 Malnutrition involving low levels of protein – decreases T-cells
Exercise improves the immune system
Influenza vaccination is very important for older adults

Physical Appearance and Movement

Wrinkles and age spots  most noticeable changes
Shorter with aging due to bone loss in their vertebrae (omurga)
Weight drops after age 60

 Muscle loss
 Exercising is beneficial for overall health and fall risk reduction

Older adults move more slowly than young adults.

Exercise and appropriate weightlifting can help reduce these declines.

Sensory Changes

 Vision
o Decline in vision becomes more pronounced
o Adaptation to dark and driving at night becomes especially difficult
 May be result of a reduction in the intensity of light reaching the retina
o Visual field becomes smaller
o Color vision declines as a result of the yellowing of the lens
 o Depth perception declines  decrease in contrast sensitivity
 Diseases of the Eye
o Cataracts: thickening of the lens; cloudy, opaque, and distorted vision
 By age 70, 30% of adults develop cataracts
o Glaucoma: damage to the optic nerve because of the pressure created by a buildup of
fluid in the eye. Can be treated with eye drops
o Macular degeneration: deterioration of the macula of the retina, the focal center of the
visual field
 Laser surgery may help
 Difficult to treat
 Major cause of blindness in old age
 Hearing
o Hearing implements are typical in late adulthood  usually due to degeneration of the
cochlea
o Some problems can be corrected by hearing aids
 Smell and Taste
o Losses begin about age 60
 Decline in smell is pronounced more in older adults
 Decline in test often leads to a desire for more seasoned foods
 Touch and Pain
o 60 to 70 % of older adults report some persistent pain
o Detect touch less in the lower extremities
o Lower pain sensitivity (but only for lower pain intensities)
o Decreased sensitivity to pain can help adults to cope with disease and injury
 However, masks injuries and illnesses that need to be treated

Perceptual motor coupling declines

 Can be improved with cognitive training and education

The Circulatory and Respiratory System

Circulatory system and lungs:
Increase in cardiovascular disease
High blood pressure more common in men than women
High blood pressure can be linked to
o Illness
o Obesity
o Anxiety
o Stiffening of blood vessels
o Lack of exercise

* lung capacity drops 40% between ages 20 – 80

* lungs lose plasticity, the chest shrinks, diaphragm weakens
Sexuality

 Sexuality and older men

o Orgasm becomes less frequent in males with age
o Many are sexually active as long as they are healthy
o Therapies have been effective in improving sexual functioning
 Sexuality and older women
o Challenge to find a partner  by age 70, about 70% of women don’t have a partner vs 35%
of men

HEALTH
Health Problems

 Probability of having some disease or illness increases with age

 Chronic diseases with slow onset and long duration are common in late adulthood
 Cardiovascular diseases, cancer, stroke (felç)

 Arthritis: an inflammation of the joints;

o Causes pain, stiffness, and movement problems
 Osteoporosis: extensive loss of bone tissue
o Women are affected more
o Linked to calcium and vitamin D deficiency; reduction in the levels of estrogen; lack of
exercise.
o Calcium-rich foods and vegetables and a regular exercise program can prevent
o Accidents – One of the significant causes of death in older adults
 Recovery is slower; exercise reduce s the risks

Exercise, Nutrition, and Weight

Exercise: a matter of life and death especially in old adulthood
Active adults are healthier and happier

Benefits:

 Increased longevity
 Prevention of common chronic diseases
 Improvement in the cellular functioning, treatment of many diseases, immune system, brain and
cognitive functioning
 Optimized body composition and less decline in motor skills as aging occurs
 Reduced the likelihood of developing mental health problems
Nutrition and weight

 Being “overweight and not fit”  a risk factor

Being “slightly overweight yet fit”  may be a protective factor
 Calorie restriction has been proven to extend the life span of certain animals, not known if this
works in humans

Controversy over vitamins and aging

Balanced diet and appropriate vitamins necessary to maintain health while aging
Antioxidants:

 Theorized to slow the aging process by neutralizing free-radical activity

 Still many uncertainties about role of antioxidant vitamins in health

Health treatment
Need to expand disease management programs

 Older adults with health problems receive necessary recommended medical care only half the
time.
 Geriatric nurses: helpful in treating the health care problems.
Development of alternative home and community-based care

 Decreased percentage of older adults who live in nursing homes

Perceived control and Mortality

A factor related to health and survival in a nursing home is the patient’s feelings of control and self-
determination.

 15 percent of residents who had more choices and felt more control were more likely to be alive
18 months later than the 30 percent who felt less control and more dependent on staff.